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已发表论文
纵向血红蛋白轨迹及其与接受每周生长激素治疗的矮小症儿童（年龄<15 岁）生长反应的关联：一项真实世界队列研究
Authors Xu Q, Yang Y, Xie L, Zhang D, Zou H, Cao L, Yang L
Received 19 May 2025
Accepted for publication 9 September 2025
Published 12 September 2025 Volume 2025:18 Pages 5433—5446
DOI https://doi.org/10.2147/IJGM.S541514
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Woon-Man Kung
Qingbo Xu,1,2 Yu Yang,1,2 Liling Xie,1,2 Dongguang Zhang,1,2 Haiying Zou,1,2 LanFang Cao,1,2 Li Yang1,2
1Department of Endocrinology, Genetics and Metabolism, Jiangxi Provincial Children’s Hospital, Nanchang, Jiangxi, 330038, People’s Republic of China; 2Department of Endocrinology, The Affiliated Children’s Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330038, People’s Republic of China
Correspondence: Li Yang, Email yangli05232@163.com
Background: Growth hormone (GH) therapy affects linear growth and may influence hematopoiesis, but dynamic hemoglobin (Hb) changes in children remain unclear.
Objective: To characterize longitudinal Hb trajectories during weekly GH treatment in short stature, including idiopathic short stature (ISS) and growth hormone deficiency (GHD), and to assess their associations with growth response.
Methods: This retrospective cohort study included 165 children with short stature who received once-weekly PEGylated GH therapy for at least 12 months. Hematologic/growth-related parameters were collected at baseline, 6 and 12 months. Group-based trajectory modeling (GBTM) identified Hb trajectory groups. Spearman correlation analysis was performed to evaluate the association between Hb, red blood cell (RBC) count, and insulin-like growth factor 1 (IGF-1). Multivariate logistic regression was used to identify predictors of Hb improvement (≥ 5 g/L).
Results: Three distinct Hb trajectory groups were identified: ascending (n = 82), ascending-then-descending (n = 51), and stable (n = 32). The ascending group demonstrated the most favorable height SDS improvement at 12 months (mean ΔHtSDS = 1.01), while the ascending-then-descending and stable groups showed more modest gains. IGF-1 levels were moderately correlated with Hb at 12 months (ρ = 0.308, p = 0.001) and RBC counts (ρ = 0.236, p = 0.014). Logistic regression revealed no independent baseline predictor of Hb improvement; however, the inclusion of Hb trajectory group significantly enhanced the predictive model for growth response (adjusted R² increased from 0.129 to 0.240; p = 0.018).
Conclusion: Hb trajectories vary significantly among children receiving GH therapy and are moderately associated with height outcomes. Longitudinal monitoring of Hb may serve as a cost-effective dynamic biomarker to guide personalized GH dose titration in pediatric growth disorders. If validated, Hb monitoring may serve as a practical biomarker for personalized GH dosing in pediatric growth disorders.
Keywords: trajectory analysis, growth hormone therapy, hemoglobin trajectory, pediatric endocrinology
1Department of Endocrinology, Genetics and Metabolism, Jiangxi Provincial Children’s Hospital, Nanchang, Jiangxi, 330038, People’s Republic of China; 2Department of Endocrinology, The Affiliated Children’s Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330038, People’s Republic of China
Correspondence: Li Yang, Email yangli05232@163.com
Background: Growth hormone (GH) therapy affects linear growth and may influence hematopoiesis, but dynamic hemoglobin (Hb) changes in children remain unclear.
Objective: To characterize longitudinal Hb trajectories during weekly GH treatment in short stature, including idiopathic short stature (ISS) and growth hormone deficiency (GHD), and to assess their associations with growth response.
Methods: This retrospective cohort study included 165 children with short stature who received once-weekly PEGylated GH therapy for at least 12 months. Hematologic/growth-related parameters were collected at baseline, 6 and 12 months. Group-based trajectory modeling (GBTM) identified Hb trajectory groups. Spearman correlation analysis was performed to evaluate the association between Hb, red blood cell (RBC) count, and insulin-like growth factor 1 (IGF-1). Multivariate logistic regression was used to identify predictors of Hb improvement (≥ 5 g/L).
Results: Three distinct Hb trajectory groups were identified: ascending (n = 82), ascending-then-descending (n = 51), and stable (n = 32). The ascending group demonstrated the most favorable height SDS improvement at 12 months (mean ΔHtSDS = 1.01), while the ascending-then-descending and stable groups showed more modest gains. IGF-1 levels were moderately correlated with Hb at 12 months (ρ = 0.308, p = 0.001) and RBC counts (ρ = 0.236, p = 0.014). Logistic regression revealed no independent baseline predictor of Hb improvement; however, the inclusion of Hb trajectory group significantly enhanced the predictive model for growth response (adjusted R² increased from 0.129 to 0.240; p = 0.018).
Conclusion: Hb trajectories vary significantly among children receiving GH therapy and are moderately associated with height outcomes. Longitudinal monitoring of Hb may serve as a cost-effective dynamic biomarker to guide personalized GH dose titration in pediatric growth disorders. If validated, Hb monitoring may serve as a practical biomarker for personalized GH dosing in pediatric growth disorders.
Keywords: trajectory analysis, growth hormone therapy, hemoglobin trajectory, pediatric endocrinology